气寒,味大辛。苦寒,味浓,阴也,降也。苦,阴中微阳。无毒。
入足阳明经,手太阴、肾经本药。
《象》云∶泻足阳明经火热,补益肾水膀胱之寒。去皮用。
《心》云∶泻肾中火,苦寒,凉心去热。
《珍》云∶凉肾,肾经本药,上颈行经,皆须用酒炒。
《本草》云∶主消渴热中,除邪气,肢体浮肿,下水,补不足,益气,疗伤寒,久疟烦
热,胁下邪气,膈中恶,及风汗内疸。多服,令人泄。
东垣云∶入足阳明、手太阴,味苦,寒润。治有汗骨蒸,肾经气劳,泻心。仲景用此为
白虎汤,治不得眠者,烦躁也。烦者,肺也;躁者,肾也。以石膏为君主,佐以知母之苦寒
,以清肾之源。缓以甘草、粳米之甘,而使不速下也。经云∶胸中有寒者,瓜蒂散吐之。又
云∶表热里寒者,白虎汤主之。瓜蒂、知母味皆苦寒,而治胸中寒及里寒,何也?答曰∶成
无己注云∶即伤寒寒邪之毒为热病也。读者要逆识之,如《论语》言∶乱臣十人,书言唯以
乱民,其能而乱四方。乱,皆治也,乃治乱者也,故云乱民,乱四方也。仲景所言“寒”之
一字,举其初而言之,热病在其中矣。若以“寒”为寒冷之寒,无复用苦寒之剂。兼言白虎
证“脉尺寸俱长”,则热可知矣。
气平,微寒,味辛、苦。无毒。
《本草》云∶主伤寒烦热,淋沥、邪气,疝瘕、喉痹,乳难,金疮,风痉。疗腹中结实
,心下满,洗洗恶风寒,目眩项直,咳嗽上气。止烦渴,出汗,安五脏,利骨髓。
仲景∶寒实结胸,外无热证者,三物小陷胸汤主之,白散亦可。以其内有贝母也。别说
,贝母能散胸中郁结之气,殊有功。
《本草》又云∶浓朴、白薇为之使,恶桃花,畏秦艽、 石、莽草,反乌头。
海藏祖方,下乳三母散∶牡蛎、知母、贝母三物为细末,猪蹄汤调下。
(知母)气性寒,味大辛。苦寒,气味浓厚,属阴,具有沉降之性。苦味,属于阴中带有微阳。无毒。
入足阳明经、手太阴肺经和肾经,是这些经络的本药。
李杲(号东垣,此处引《象》可能指王好古或前人对李杲观点的归纳,原文作《象》,通常指张元素之子张璧所著《医学启源》中的“象”字辈论述,或指李杲《珍珠囊补遗药性赋》等,此处依原文直译)说:清泻足阳明经的火热,补益肾水和膀胱的寒气。使用时需去皮。
李杲(《心》可能指其著作或观点)说:清泻肾中的火,因其苦寒,能凉心去热。
王好古(《珍》可能指其著作《汤液本草》或相关论述)说:凉肾,是肾经的本药,上行至颈部及经脉,都必须用酒炒制。
《本草》说:主治消渴病和中焦热盛,祛除邪气,治疗肢体浮肿,通利水道,补益不足,益气,治疗伤寒、久疟疾引起的烦热,胁下的邪气,胸膈间的恶气,以及风汗和内疸。多服会导致腹泻。
李杲说:入足阳明经、手太阴肺经,味苦,性寒而润。治疗有汗的骨蒸劳热,肾经的气劳,清泻心火。张仲景将其用于白虎汤,治疗无法入睡的症状,这是烦躁的表现。烦,属于肺;躁,属于肾。以石膏为君药,佐以知母的苦寒,以清解肾热的源头。用甘草、粳米的甘缓之性,使其不致过快下行。经文说:胸中有寒邪的,用瓜蒂散催吐。又说:表热里寒的,用白虎汤主治。瓜蒂和知母的味道都是苦寒的,却分别用于治疗胸中寒和里寒,为什么呢?回答是:成无己注释说:这就是伤寒寒邪的毒气转化为热病。读者要逆向理解这一点,就像《论语》中说:“乱臣十人”,《尚书》中说“唯以乱民”,能够治理四方。这里的“乱”,都是治理的意思,即治乱者,所以说“乱民”,治理四方。张仲景所说的“寒”字,是从病因初起而言的,热病已经包含在其中了。如果把“寒”理解为寒冷的寒,就不必再用苦寒的药物了。加上白虎汤证的“脉尺寸俱长”,那么热证就可以知道了。
(贝母)气性平,微寒,味辛、苦。无毒。
《本草》说:主治伤寒烦热,淋沥涩痛、邪气,疝瘕积聚、喉痹,乳汁不通,金疮,风痉。治疗腹中结实,心下痞满,洒淅恶风寒,目眩项强,咳嗽气逆。止烦渴,出汗,安五脏,利骨髓。
张仲景:对于寒实结胸,体表没有热证的,用三物小陷胸汤主治,白散也可以。因为方中含有贝母。另有说法,贝母能疏散胸中郁结之气,功效显著。
《本草》又说:厚朴、白薇是其使药,畏桃花,害怕秦艽、石韦(注:原文“石”后缺字,结合上下文及中药配伍禁忌,常指石韦或类似药物,此处保留原文“石”)、莽草,与乌头相反。
海藏(张元素,号海藏老人)祖传方剂,下乳三母散:牡蛎、知母、贝母三味药研为细末,用猪蹄汤调服。
(Zhimu) The qi is cold, and the flavor is greatly pungent. It is bitter and cold, with a dense flavor, belonging to Yin, possessing a descending nature. Bitterness belongs to Yin but contains slight Yang. It is non-toxic.
It enters the Foot-Yangming Meridian, Hand-Taiyin Lung Meridian, and Kidney Meridian, serving as the principal herb for these meridians.
Xiang states: It clears and drains the fire-heat of the Foot-Yangming Meridian and tonifies the cold of Kidney Water and the Bladder. The skin should be removed before use.
Xin states: It clears and drains fire in the Kidneys; being bitter and cold, it cools the Heart and removes heat.
Zhen states: It cools the Kidneys and is the principal herb of the Kidney Meridian. When ascending to the neck and meridians, it must be stir-fried with wine.
Bencao states: It primarily treats Xiao Ke (Wasting-Thirst) and internal heat, eliminates pathogenic factors, treats edema of the limbs, promotes urination to drain water, tonifies deficiencies, benefits Qi, treats Shang Han (Cold Damage), chronic malaria with vexation and heat, pathogenic factors under the hypochondrium, evil stagnation in the diaphragm, wind-induced sweating, and internal jaundice. Excessive consumption causes diarrhea.
Dongyuan states: It enters the Foot-Yangming and Hand-Taiyin meridians; its flavor is bitter, and its nature is cold and moistening. It treats bone-steaming fever with sweating, Qi exhaustion of the Kidney Meridian, and drains the Heart. Zhang Zhongjing uses this herb in Baihu Tang (White Tiger Decoction) to treat insomnia caused by restlessness. Vexation (Fan) relates to the Lung; Restlessness (Zao) relates to the Kidney. Shi Gao (Gypsum Fibrosum) serves as the Sovereign herb, assisted by the bitter-cold nature of Zhi Mu to clear the source of Kidney heat. Gan Cao (Licorice Root) and Jing Mi (Millet) are used for their sweet and緩 (slowing) properties to prevent the formula from acting too rapidly downward. The Classic states: For cold in the chest, use Gua Di San (Melon Sepal Powder) to induce vomiting. It also states: For exterior heat and interior cold, Baihu Tang (White Tiger Decoction) is the primary treatment. Both Gua Di (Melon Sepal) and Zhi Mu are bitter and cold, yet they treat cold in the chest and interior cold respectively. Why? The answer is: Cheng Wuji’s annotation explains that this refers to the toxicity of Cold Pathogens in Shang Han transforming into Heat Diseases. Readers must understand this inversely. As the Analects mentions "ten ministers who caused chaos," and the Book of Documents says "only using chaotic people" to govern the four quarters, the word "chaos" here implies governance—those who pacify chaos. Thus, "chaotic people" means those who govern the world. Zhang Zhongjing’s use of the character "cold" refers to the initial etiology, within which the Heat Disease is contained. If "cold" were interpreted merely as physical coldness, there would be no need to employ bitter-cold agents. Furthermore, the Baihu Tang syndrome features "long pulses at both cun and chi positions," indicating heat.
(Beimu) The qi is neutral, slightly cold, with pungent and bitter flavors. It is non-toxic.
Bencao states: It primarily treats vexation and heat from Shang Han, painful urinary dysfunction, pathogenic factors, hernia and masses, throat obstruction, difficulty in lactation, traumatic injuries, and wind-induced spasms. It treats solid accumulations in the abdomen, fullness below the heart, aversion to wind and cold with shivering, dizziness, stiff neck, cough with rebellious Qi, stops vexation and thirst, induces sweating, calms the Five Zang Organs, and benefits the bone marrow.
Zhang Zhongjing: For Cold-Excess Jie Xiong (Chest Binding) without exterior heat signs, San Wu Xiao Xian Xiong Tang (Three-Ingredient Small Trap Chest Formula) is the primary treatment; Bai San (White Powder) may also be used because it contains Bei Mu. Another view states that Bei Mu can disperse stagnant Qi in the chest, achieving significant merit.
Bencao further states: Hou Po (Magnolia Bark) and Bai Wei (Cynanchum Root) act as its guides. It clashes with Tao Hua (Peach Blossom), fears Qin Jiao (Gentiana Macrophylla), Shi [Wei] (likely Shi Wei or similar), and Mang Cao (Artemisia Anethifolia), and is incompatible with Wu Tou (Aconite).
Haizang’s ancestral formula, Xia Ru San Mu San (Nursing Milk Three Mothers Powder): Mu Li (Oyster Shell), Zhi Mu, and Bei Mu are ground into fine powder and taken with Pig Trotter Decoction.